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Articles 661 - 690 of 3625
Full-Text Articles in International Public Health
A Man With Acute Severe Pneumonia: Case Discussion From The University Of Louisville Hospital, Viswanathan Nagarajan, Srinivas R. Dontineni, Veronica Corcino, Forest W. Arnold
A Man With Acute Severe Pneumonia: Case Discussion From The University Of Louisville Hospital, Viswanathan Nagarajan, Srinivas R. Dontineni, Veronica Corcino, Forest W. Arnold
The University of Louisville Journal of Respiratory Infections
No abstract provided.
Current And Future Antiviral Medications To Treat Influenza: Mechanisms Of Action, Julio A. Ramirez
Current And Future Antiviral Medications To Treat Influenza: Mechanisms Of Action, Julio A. Ramirez
The University of Louisville Journal of Respiratory Infections
No abstract provided.
An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández
An Iterative Process For Training Design And Implementation Increased Health Workers' Knowledge For Taking Nutrition Behavior Change To Scale, Wendy Gonzalez, Anabelle Bonvecchio Arenas, Armando García-Guerra, Mireya Vilar-Compte, Alejandría Villa De La Vega, Laura Quezada, Cynthia Rosas, Ana Lilia Lozada-Tequeanes, Amira Hernández
Department of Public Health Scholarship and Creative Works
The shortage of skilled, motivated, and well-supported health workers is a major barrier to scaling up nutrition interventions and services. Objective: The objective of this study is to describe the process for developing and implementing a training of health personnel for the delivery of the Integrated Strategy for Attention to Nutrition (EsIAN), an evidence-based strategy for promoting infant and young child feeding through primary health care in Mexico. The specific objective is to provide a case study and highlight challenges, as well as elements to successfully mitigate these, and discuss potential applications of findings beyond the Mexican context. Methods: The …
Development Of A Real-Time Pcr Assay For Pneumocystis Jirovecii On The Luminex Aries® Platform, Subathra Marimuthu, Kuldeep Ghosh, Leslie A Wolf
Development Of A Real-Time Pcr Assay For Pneumocystis Jirovecii On The Luminex Aries® Platform, Subathra Marimuthu, Kuldeep Ghosh, Leslie A Wolf
The University of Louisville Journal of Respiratory Infections
Pneumocystis pneumonia (PCP) is an opportunistic infection caused by the fungus Pneumocystis jirovecii. Infection with P. jirovecii can result in serious illness in patients with a weakened immune system, and can lead to death if it is not properly diagnosed and treated. Direct detection of P. jirovecii in lower respiratory tract specimens such as bronchoalveolar lavage (BAL) is preferred for rapid diagnosis, a laboratory service currently not available locally. We report here the development of a diagnostic real-time Polymerase Chain Reaction (PCR) assay using BAL specimens to detect P. jirovecii. By targeting the multi-copy mitochondrial large subunit ribosomal …
A Qualitative Metasynthesis Of Published Research Exploring The Pregnancy And Resettlement Experience Among Refugee Women, Diana M. Kingsbury, Sheryl L. Chatfield
A Qualitative Metasynthesis Of Published Research Exploring The Pregnancy And Resettlement Experience Among Refugee Women, Diana M. Kingsbury, Sheryl L. Chatfield
The Qualitative Report
The number of refugees and asylum seekers throughout the world continues to increase, leading to increasing challenges in meeting healthcare needs of these individuals. Women’s antenatal health is of particular concern due to their vulnerability to sexual violence and the substantial proportion of refugees consisting of women and girls of or nearing reproductive age. The purpose of this qualitative metasynthesis was to integrate and interpret findings from previously published research reports in which authors explored aspects of pregnancy among resettled refugee women. Following a systematic search process, we used Dedoose qualitative data analysis software to manage the process of extracting …
Towards Multi-Lingual Pneumonia Research Data Collection Using The Community-Acquired Pneumonia International Cohort Study Database, William A. Mattingly, Kimberley A. Buckner, Senen Pena
Towards Multi-Lingual Pneumonia Research Data Collection Using The Community-Acquired Pneumonia International Cohort Study Database, William A. Mattingly, Kimberley A. Buckner, Senen Pena
The University of Louisville Journal of Respiratory Infections
Background: Although multilingual interfaces are preferred by most users when they have a choice, organizations are often unable to support and troubleshoot problems involving multiple user languages. Software that has been structured with multiple languages and data interlinking considerations early in its development is more likely to be easily maintained. We describe the process of adding multilingual support to the CAPO international Cohort study database using REDCap.
Methods: Using Google Translate API we extend the supported Spanish language version of REDCap to the most recent version used by CAPO, 8.1.4. We then translate the English data dictionary for CAPO to …
Clinical Research In Pneumonia: Role Of Artificial Intelligence, Timothy L. Wiemken, Robert R. Kelley, William A. Mattingly, Julio A. Ramirez
Clinical Research In Pneumonia: Role Of Artificial Intelligence, Timothy L. Wiemken, Robert R. Kelley, William A. Mattingly, Julio A. Ramirez
The University of Louisville Journal of Respiratory Infections
No abstract provided.
A Multicountry Randomized Controlled Trial Of Comprehensive Maternal Nutrition Supplementation Initiated Before Conception: The Women First Trial., K. Michael Hambidge, Jamie E. Westcott, Ana Garcés, Lester Figueroa, Shivaprasad S. Goudar, Sangappa M. Dhaded, Omrana Pasha, Sumera A. Ali, Antoinette Tshefu, Adrien Lokangaka, Richard J. Derman, Robert L. Goldenberg, Carl L. Bose, Melissa Bauserman, Marion Koso-Thomas, Vanessa R. Thorsten, Amaanti Sridhar, Kristen Stolka, Abhik Das, Elizabeth M. Mcclure, Nancy F. Krebs
A Multicountry Randomized Controlled Trial Of Comprehensive Maternal Nutrition Supplementation Initiated Before Conception: The Women First Trial., K. Michael Hambidge, Jamie E. Westcott, Ana Garcés, Lester Figueroa, Shivaprasad S. Goudar, Sangappa M. Dhaded, Omrana Pasha, Sumera A. Ali, Antoinette Tshefu, Adrien Lokangaka, Richard J. Derman, Robert L. Goldenberg, Carl L. Bose, Melissa Bauserman, Marion Koso-Thomas, Vanessa R. Thorsten, Amaanti Sridhar, Kristen Stolka, Abhik Das, Elizabeth M. Mcclure, Nancy F. Krebs
Global Health Articles
Background: Reported benefits of maternal nutrition supplements commenced during pregnancy in low-resource populations have typically been quite limited.
Objectives: This study tested the effects on newborn size, especially length, of commencing nutrition supplements for women in low-resource populations ≥3 mo before conception (Arm 1), compared with the same supplement commenced late in the first trimester of pregnancy (Arm 2) or not at all (control Arm 3).
Methods: Women First was a 3-arm individualized randomized controlled trial (RCT). The intervention was a lipid-based micronutrient supplement; a protein-energy supplement was also provided if maternal body mass index (kg/m2) was(DRC), Guatemala, India, and …
"Disgusted With Myself": Examining The Risk Factors And Vulnerabilities Of Hostesses At Karaoke Tv Venues In Phnom Penh, Cambodia, Glenn M. Miles, Daphne Alsiyao
"Disgusted With Myself": Examining The Risk Factors And Vulnerabilities Of Hostesses At Karaoke Tv Venues In Phnom Penh, Cambodia, Glenn M. Miles, Daphne Alsiyao
Dignity: A Journal of Analysis of Exploitation and Violence
This exploratory study is one of a series of research projects interviewing survivors of sexual exploitation in southeast Asia. It assesses the risk factors and vulnerabilities of young women in Karaoke TV (KTV) venues in Phnom Penh, Cambodia. This research study assesses the risk factors and vulnerabilities of young women in these venues. A questionnaire-based survey was administered to 50 participants to gain a holistic view of the lives of young women working in Karaoke TV (KTV) venues. The survey consisted of a series of questions pertaining to demographics, family background, prejudice and discrimination, sexual risk factors, substance abuse, sexual …
Severity Of Disease And Mortality For Hospitalized Patients With Community-Acquired Viral Pneumonia Compared To Patients With Community-Acquired Bacterial Pneumonia, Richard Y. Kim, Thomas Chandler, Stephen P. Furmanek, Timothy Lee Wiemken, Rodrigo Cavallazzi
Severity Of Disease And Mortality For Hospitalized Patients With Community-Acquired Viral Pneumonia Compared To Patients With Community-Acquired Bacterial Pneumonia, Richard Y. Kim, Thomas Chandler, Stephen P. Furmanek, Timothy Lee Wiemken, Rodrigo Cavallazzi
The University of Louisville Journal of Respiratory Infections
Background: There exists a large body of literature to help identify, diagnose, treat, and manage community-acquired pneumonia (CAP). Despite this, there is little data that directly compares the clinical syndromes and complications of pure bacterial pneumonia to pure viral pneumonia. Our study compares the clinical presentation, morbidity and mortality of viral vs. bacterial etiologies of CAP.
Methods: This was a secondary data analysis of the Community-Acquired Pneumonia Organization (CAPO) international study database. Data was collected concerning patient demographics, physical examination findings, laboratory findings, radiological findings, severity of illness, and clinical outcomes and stratified according to the two study groups, CAVP …
Carbapenem-Resistant Enterobacteriaceae Infections: A Review Of Epidemiology And Treatment Options, Julie Harting
Carbapenem-Resistant Enterobacteriaceae Infections: A Review Of Epidemiology And Treatment Options, Julie Harting
The University of Louisville Journal of Respiratory Infections
No abstract provided.
Sharing The Gift Of Water: A Hoosier-Haitian Partnership, Lauren Ward
Sharing The Gift Of Water: A Hoosier-Haitian Partnership, Lauren Ward
Purdue Journal of Service-Learning and International Engagement
Engagement Methods for International Food Security (YDAE 49100) provided an opportunity for enrolled students to travel abroad to Cap-Haitïen, Haiti. As both a course in agriculture and a service-learning study abroad, the overarching goal was to inspire, engage, and teach Purdue and Haitian students through service learning in agriculture. This was done by developing a project with teammates during the fall semester that was then presented to students in Haiti during the International Agri-Symposium at Université Antenor Firmin over winter break.
Depression Among Epileptic Patients And Its Association With Drug Therapy In Sub-Saharan Africa: A Systematic Review And Meta-Analysis., Getenet Dessie, Henok Mulugeta, Cheru Tesema Leshargie, Fasil Wagnew, Sahai Burrowes
Depression Among Epileptic Patients And Its Association With Drug Therapy In Sub-Saharan Africa: A Systematic Review And Meta-Analysis., Getenet Dessie, Henok Mulugeta, Cheru Tesema Leshargie, Fasil Wagnew, Sahai Burrowes
BACKGROUND: Despite the high prevalence of epilepsy in sub-Saharan Africa and the established relationship between depression and epilepsy, the extent of comorbid epilepsy and depression in the region is still poorly understood. The objective of this systematic review and meta-analysis is to address this gap in the literature by determining the pooled prevalence of depression among epileptic patients in sub-Saharan Africa.
METHODS: A systematic desk review and electronic web-based search of PubMed, Google Scholar, EMBASE, PsycINFO and the World Health Organization's Hinari portal (which includes the SCOPUS, African Index Medicus, and African Journals Online databases) conducted from December 2, 2017 …
Reaching Key Populations With Community-Based Hiv Test And Start Services In Lagos And Benue States In Nigeria: Baseline Findings, Project Soar
HIV and AIDS
Key populations (KPs), such as men who have sex with men (MSM), female sex workers (FSWs), and people who inject drugs, remain disproportionately affected by HIV compared to the general population. In Nigeria, HIV prevalence declined among the general population from 2007–18. Among key populations from 2007–14, HIV also decreased among FSWs, but increased among MSM. Evidence-based strategies to sustain the decline among the general population and FSWs, and mitigate the increase among MSM, are needed. Nigeria has adopted the World Health Organization’s “test and start” (TnS) strategy, which recommends initiating antiretroviral therapy (ART) by persons living with HIV as …
Meeting The Needs Of Orphans And Other Vulnerable Children: Learnings From Project Soar, Project Soar
Meeting The Needs Of Orphans And Other Vulnerable Children: Learnings From Project Soar, Project Soar
HIV and AIDS
Orphans and other vulnerable children (OVC), including those living with HIV, often have a range of unmet needs, such as education, food security, psychosocial support, and access to health care. Project SOAR is documenting the unique vulnerabilities of OVC and their caregivers, and examining strategies to mitigate the impacts of HIV on them. This brief presents a summary of the SOAR portfolio, including a prospective cohort study of young people living with HIV in Zambia, an evaluation of an HIV risk screening tool among OVC in Tanzania, and a systematic review of promising interventions to support engagement and treatment adherence …
Smoking Tobacco Prevalence Among College Students In The Kingdom Of Saudi Arabia: Systematic Review And Meta-Analysis, Saad A. Alotaibi, Mohammed A. Alsuliman, Praveen K. Durgampudi
Smoking Tobacco Prevalence Among College Students In The Kingdom Of Saudi Arabia: Systematic Review And Meta-Analysis, Saad A. Alotaibi, Mohammed A. Alsuliman, Praveen K. Durgampudi
Community & Environmental Health Faculty Publications
INTRODUCTION:
During the last two decades, several studies have been published regarding the prevalence of tobacco smoking among college students in the Kingdom of Saudi Arabia (KSA). This systematic review and meta-analysis is intended to determine and examine the smoking prevalence in Saudi college students from 2010-2018.
METHODS:
PubMed, Science Direct, APA PsycNET, Web of Science, and CINAHL were used to search for published articles reporting the smoking prevalence among Saudi college students. After eliminating irrelevant articles, investigators independently assessed the quality of each article, based on Russell & Gregory guidelines. MetaXL software was used to calculate the pooled prevalence …
Family-Based Intervention For Patients With Type 2 Diabetes Via Wechat In China: Protocol For A Randomized Control Trial, Linqi Mao, Jun Lu, Qi Zhang, Yuxi Zhao, Gang Chen, Mei Sun, Fengshui Chang, Xiaohong Li
Family-Based Intervention For Patients With Type 2 Diabetes Via Wechat In China: Protocol For A Randomized Control Trial, Linqi Mao, Jun Lu, Qi Zhang, Yuxi Zhao, Gang Chen, Mei Sun, Fengshui Chang, Xiaohong Li
Community & Environmental Health Faculty Publications
Background
China has the largest number of cases of diabetes with a high rate of uncontrolled blood sugar. Many studies show that family members’ involvement is related to better glycemic control. However, there is a significant problem with low participation of family members. The widespread use of WeChat provides an opportunity for family members to support their diabetic loved ones in their type 2 diabetes self-management practices. The main aim of this study is to examine the effectiveness of a family-based intervention via WeChat.
Methods
A parallel, two-group, randomized controlled trial will be conducted in the central urban area of …
Women And Hiv: Understanding And Addressing Stigma—Evidence From The Population Council, Population Council
Women And Hiv: Understanding And Addressing Stigma—Evidence From The Population Council, Population Council
HIV and AIDS
Over the last 20 years, the Population Council has carried out extensive work examining the intersection of stigma and gender and its impact on HIV-related outcomes. This brief summarizes key Population Council findings from a range of studies which elucidate the experiences of stigma among women and highlights avenues for addressing stigma to mitigate women’s risk and burden of HIV.
Strengthening Capacity To Prevent Hiv Among Adolescent Girls And Young Women: Supporting Dreams Programming, Project Soar
Strengthening Capacity To Prevent Hiv Among Adolescent Girls And Young Women: Supporting Dreams Programming, Project Soar
HIV and AIDS
The Population Council, with funding from Girl Effect, worked in seven Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe (DREAMS) Partnership countries to strengthen the capacity of implementing partners to develop new approaches to reach AGYWs at highest risk of HIV infection, link them with essential resources, and empower them with social and protective assets for a safe and healthy entry into adulthood. This technical assistance was informed by the Population Council’s decades of research and experience determining “what works”—and what doesn’t work—in girl-centered programming. Through Project SOAR, the Population Council provided technical assistance to implementing partners in five additional countries …
Implementing And Scaling-Up Stepping Stones In Kwazulu-Natal, South Africa: Lessons From Working In Informal Settlements, Cecilia Milford, M. Mtshali, Mags Beksinska, Julie Pulerwitz
Implementing And Scaling-Up Stepping Stones In Kwazulu-Natal, South Africa: Lessons From Working In Informal Settlements, Cecilia Milford, M. Mtshali, Mags Beksinska, Julie Pulerwitz
HIV and AIDS
KwaZulu-Natal (KZN), a major epicenter of the South African HIV epidemic, has large informal settlements where thousands of people live. The settlements are often underserved by municipal services and lack accessible health care. Given high rates of HIV, there is a critical need to assess the successes and challenges of implementing HIV prevention and treatment in this context. Stepping Stones is a widely used life-skills training intervention focused on curbing gender-based violence and reducing HIV risk. The program addresses issues such as communication about HIV, relationship skills, and assertiveness. The manual-based curriculum encourages participants to engage in critical reflection through …
The People Living With Hiv Stigma Index: Dominican Republic, Red Dominicana De Personas Que Viven Con Vih/Sida, Alianza Solidaria Para La Lucha Contra El Vih Y Sida, Population Council
The People Living With Hiv Stigma Index: Dominican Republic, Red Dominicana De Personas Que Viven Con Vih/Sida, Alianza Solidaria Para La Lucha Contra El Vih Y Sida, Population Council
HIV and AIDS
The People Living with HIV Stigma Index, developed in 2008, is a survey instrument used to highlight stigma and discrimination experienced by PLHIV. Developed and administered by and for PLHIV, the Stigma Index is not merely a measurement tool, its implementation is intended to be an empowering experience for PLHIV. In 2016–17, the Population Council–led research consortium Project SOAR updated the Stigma Index to reflect changes in the global HIV response in the past decade. The new version (Stigma Index 2.0) now has an increased focus on PLHIV’s experiences accessing HIV services; using and adhering to antiretroviral services; mental health …
Índice De Estigma En Personas Viviendo Con Vih 2.0: Resultados Preliminares Para La República Dominicana, Project Soar
Índice De Estigma En Personas Viviendo Con Vih 2.0: Resultados Preliminares Para La República Dominicana, Project Soar
HIV and AIDS
El estigma y la discriminación hacia las personas que viven con el VIH (PVVIH) contribuyen a la pobre calidad de servicios de salud, coerción y violencia, desempleo y exclusión de las reuniones sociales. Abordar el estigma que afecta a las PVVIH es una prioridad mundial, dado su impacto en la epidemia del VIH. En 2008, la Red mundial de personas que viven con el VIH, la Comunidad internacional de mujeres que viven con el VIH, la Federación Internacional de Planificación de la Familia y ONUSIDA lanzaron el Índice de Estigma para proveer evidencia sobre estigma y discriminación que sirva para …
Índice De Estigma En Personas Que Viven Con Vih: República Dominicana, Red Dominicana De Personas Que Viven Con Vih/Sida, Alianza Solidaria Para La Lucha Contra El Vih Y Sida, Population Council
Índice De Estigma En Personas Que Viven Con Vih: República Dominicana, Red Dominicana De Personas Que Viven Con Vih/Sida, Alianza Solidaria Para La Lucha Contra El Vih Y Sida, Population Council
HIV and AIDS
El Índice de Estigma de las personas que viven con el VIH, desarrollado en 2008, es una encuesta utilizada para identificar el estigma y la discriminación que enfrentan las PVVIH. Desarrollado y administrado por y para las PVVIH, el Índice de Estigma es más que un simple instrumento de medición, e espera que su ejecución empodere a PVVIH. En 2016-17, el consorcio de investigación liderado por el Population Council, el Proyecto SOAR, actualizó el Índice de Estigma a modo de reflejar los cambios en la respuesta mundial ante el VIH durante la última década. La nueva versión (Stigma Index 2.0) …
The People Living With Hiv Stigma Index 2.0: Preliminary Results From The Dominican Republic, Project Soar
The People Living With Hiv Stigma Index 2.0: Preliminary Results From The Dominican Republic, Project Soar
HIV and AIDS
Stigma and discrimination among people living with HIV (PLHIV) contributes to poor quality health care, coercion and violence, job loss, and exclusion from social gatherings. Addressing stigma affecting PLHIV is a global priority, given its impact on the HIV epidemic. In 2008, the Global Network of People Living with HIV, the International Community of Women Living with HIV, the International Planned Parenthood Federation, and UNAIDS launched the People Living with HIV Stigma Index (Stigma Index) to provide evidence on stigma and discrimination that can be used to advocate for the rights of PLHIV. As of November 2017, more than 100,000 …
Global Health Elective: Santo Domingo, Dominican Republic, Joan Strong
Global Health Elective: Santo Domingo, Dominican Republic, Joan Strong
Posters
Describes the experiences of a pediatric anesthesiology fellow's time working Medical Aid for Children of Latin America (MACLA) in Santo Domingo, Dominican Republic.
An Oasis In The Hospital Desert – General Aviation Meets Medicine, Ariel Braverman
An Oasis In The Hospital Desert – General Aviation Meets Medicine, Ariel Braverman
International Journal of Aviation, Aeronautics, and Aerospace
Use of General Aviation and to support medical services is not novel. However, this paper is an attempt to establish a concept of a framework of using aviation, especially relatively low-operational cost fixed-wing aircraft as a convenient high-speed transport to bring medical staff to the rural and remote areas. Operating flight network will also be more efficient from the financial point of view - better than attracting medical personnel with high salaries. Existing regional and local airport system can be a feasible basis for airport-based medical network. This article is just an initial one and additional work needs to evaluate …
The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council
The Medicalisation Of Female Genital Mutilation/Cutting In Kenya: Perspectives Of Families And Health Care Providers, Population Council
Reproductive Health
This evidence brief summarizes key findings from a study that sought to understand the shifts in FGM/C including medicalization among several communities Kenya. The study finds that medicalization is increasing because: 1) it is perceived to be safer because the procedure is reportedly performed under sterile conditions by trained health professionals; 2) it is believed to shorten the recovery period; and 3) it is a response to the law prohibiting the practice because it allows FGM/C to be performed in secret. These findings indicate that medicalization is an adaptation to awareness of the health complications associated with FGM/C and the …
The Global Compact On Refugees: How The Sauti/Voice Project Fits, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba
The Global Compact On Refugees: How The Sauti/Voice Project Fits, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba
Reproductive Health
How can stakeholders support refugees in the present-day unprecedented global refugee crisis? At least one way is by entering into a clearly defined compact to do so. Developed in 2018, the Global Compact on Refugees is a nonbinding agreement among United Nations Member States and other relevant stakeholders, including international organizations. A symbol of political will, the Compact demonstrates the commitment of the international community to enhanced cooperation and solidarity with both refugees and their host communities. The Global Compact on Refugees provides the international community with guidance for supporting present-day refugee communities, characterized by large populations and protracted refugee …
Sauti/Voice Project: First Unhcr-Population Council Regional Workshop, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo
Sauti/Voice Project: First Unhcr-Population Council Regional Workshop, Josephine Ngebeh, Chi-Chi Undie, Joanina Karugaba, George Odwe, Nachela Chelwa, Harriet Birungi, Michael Mbizvo
Reproductive Health
In 2014, the UNHCR East and Horn of Africa and Great Lakes (EHAGL) Africa Bureau in Nairobi, and the Population Council/Nairobi established technical cooperation for Improving Evidence-based Programming for Sexual and Gender-based Violence (SGBV) in Refugee Operations in the East and Horn of Africa. The Africa Bureau works closely with the Council to initiate appropriate interventions for the prevention of, and response to, SGBV in refugee operations. The Council’s technical team is represented by the Council-led Africa Regional SGBV Network. Technical cooperation between the Africa Bureau and the Council has resulted in a new initiative: VOICE—Violence Prevention and Response Through …
Global Health Experience In Botswana, Sarah Bieser
Global Health Experience In Botswana, Sarah Bieser
Posters
Describes experience providing care at the Botswana-Baylor Children's Center of Excellence in Gabarone, Botswana and the Princess Marina Hospital.